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Statin-associated autoimmune myopathy (SAAM), also known as anti-HMGCR myopathy, is a very rare form of muscle damage caused by the immune system in people who take statin medications. [1] However, there are cases of SAAM in patients who have not taken statin medication, and this can be explained by the exposure to natural sources of statin ...
Common types of myopathy due to statins include myalgia, myositis, and rhabdomyolysis. Statins induce myopathy by inhibiting protein synthesis within the muscle. [6] Statin therapy tends to not show any histopathological differences, and thus a biopsy does not reveal too much about the damage. Often, the damage is found within the mitochondria.
Other statins have a small risk of 0.44 cases per 10 000 person-years. [9] Previous chronic kidney disease and hypothyroidism increase the risk of myopathy due to statins. It is also more common in the elderly, those who are severely disabled, and when statins are used in combination with particular other medicines, such as ciclosporin. [14] [9]
The risk of statin-induced rhabdomyolysis increases with older age, use of interacting medications such as fibrates, and hypothyroidism. [95] [96] Coenzyme Q10 (ubiquinone) levels are decreased in statin use; [97] CoQ10 supplements are sometimes used to treat statin-associated myopathy, though evidence of their efficacy is lacking as of 2017. [98]
Statin-induced rhabdomyolysis is rare, occurring in less than 0.1% of people who take statins. [ 66 ] [ 67 ] [ 68 ] Statin induced rhabdomyolysis, as with other statin associated muscle symptoms, occurs most commonly in the first year of treatment but can occur at any time during treatment. [ 66 ]
Metabolic myopathies, which affect the production of ATP within the muscle cell, typically present with dynamic (exercise-induced) rather than static symptoms. [4] Most of the inflammatory myopathies can have a chance association with malignant lesion; the incidence appears to be specifically increased only in patients with dermatomyositis.
The presence of anti HMG-CoA reductase antibodies is seen in people with statin-associated autoimmune myopathy, which is a very rare form of muscle damage caused by the immune system in people who take statin medications. [24] The exact mechanism is unclear.
The symptoms of a metabolic myopathy can be easily confused with the symptoms of another disease. As genetic sequencing research progresses, a non-invasive neuromuscular panel DNA test can help make a diagnosis. Whole genome sequencing is required in more complex cases. [1]